Organization
SHELLEY ANN LYLE DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELLEY ANN LYLE DDS (CEO)
(573) 442-1869
Entity
Organization
Contact information
Practice address
3111 KEENE CT, COLUMBIA, MO 65201-6639
(573) 442-1869
(573) 442-4165
Mailing address
3111 KEENE CT, COLUMBIA, MO 65201-6639
(573) 442-1869
(573) 442-4165
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
014131
MO
Other
Enumeration date
04/30/2008
Last updated
04/30/2008
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